Lung involvement in leptospirosis

We reviewed a series of 5 cases of leptospirosis treated in our hospital between 1998 and 2004 and found that lung involvement was observed in 3 of the 5 cases. All patients met the criteria for the diagnosis of leptospirosis. Weil syndrome was diagnosed in 4 patients and anicteric leptospirosis in 1 patient. The 3 patients with lung sequelae were admitted into the intensive care unit because of severe respiratory failure. All patients responded to antibiotic treatment; 3 received doxycycline and 2 received doxycycline with penicillin G. Leptospirosis can lead to severe lung complications often requiring admission to the intensive care unit. The degree of severity is independent of the particular clinical syndrome (the anicteric form or Weil syndrome). Finally, despite the severity of the clinical picture, our patients responded to medical treatment and did not require invasive mechanical ventilation.